Site icon Statewide Independent Living Council of Hawaii

Boards and Commissions Application

SILC Membership Application

Accessibility and Functional Needs
To make the process below as accessible as possible, the SILC committee is committed to accommodating various needs. If you, or your caregiver, encounter any challenges due to vision, hearing, mobility, cognitive, neurodiverse needs, language barriers, technical limitations or other disabilities, we are here to support you. Alternative formats, such as large print, Braille, simplified text, audio assistance, or one one one help with filling out the application, are available upon request. Please don’t hesitate to call the phone number below for further assistance or to discuss specific accommodations that might work best for you.

Step 1 of 5

Legal Name(Required)
Residential Address(Required)
(###) ###-####
Do you identifies as a person with a disability?
Do you consider yourself an ally or champion for people with disabilities?
Are you willing to share your personal lived or learned experience?

Reference #1

Name
(###) ###-####

Reference #2

Name
(###) ###-####

Reference #3

Name
(###) ###-####

Are you currently serving on any board, commission, or council created by the State Constitution or a state statute?

Max. file size: 80 MB.
This field is for validation purposes and should be left unchanged.

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